Posterior Horn of Medial Meniscal Peripheral Capsular Lesion: The Arthroscopic Repair Technique Working in the Posterior Compartment  Pinkawas Kongmalai, M.D., Bancha Chernchujit, M.D.  Arthroscopy Techniques  Volume 5, Issue 4, Pages e763-e767 (August 2016) DOI: 10.1016/j.eats.2016.03.001 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Flowchart of the arthroscopic repair of the posterior horn of medial meniscal peripheral capsular lesion working from the posterior compartment. (PL, posterolateral; PM, posteromedial.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Arthroscopic picture of the left knee in supine position with the knee flexed to 90°. Viewing from the camera in the anterolateral portal, the location of the low and high posteromedial portal is shown (green and blue star, respectively). (MFC, medial femoral condyle; PHMM, posterior horn of the medial meniscus; PM, posteromedial.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Comparison of the visualization of the posterior horn of medial meniscal capsular lesion (star) of the left knee between the arthroscope from the anterolateral portal (A) and the posterolateral portal (B). (MFC, medial femoral condyle; PHMM, posterior horn of the medial meniscus; PM-Cap, posteromedial capsule.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 The outside picture when working from the posterior compartment of the left knee. The camera was placed in the posterolateral portal for viewing (thin arrow), and the cannula was placed in the high posteromedial portal (thick arrow); the inset shows the motorized shaver through the low posteromedial portal (star). (MFC, medial femoral condyle; PHMM, posterior horn of the medial meniscus; PM-Cap, posteromedial capsule.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 With the camera in the posterolateral portal (thin arrow), the inset shows that the suture hook device was inserted from the low posteromedial portal (star) and passed from posterior to anterior of the tear site. Note that the thick arrows (both inside and outside views) are the first suture that was already passed through the meniscal fragment beginning from the medial site and temporarily kept in the low posteromedial portal. (MFC, medial femoral condyle; PHMM, posterior horn of the medial meniscus; PM-Cap, posteromedial capsule.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic knot pusher was used to tie the knot from the lateral to medial direction in the cannula from the high posteromedial portal (thick arrow). Note that the camera was always placed in the posterolateral portal during the repair process (thin arrow). The inset shows that the first pair of suture that was tied is the most lateral one, whereas the other pairs were kept in the low posteromedial portal (star). (MFC, medial femoral condyle; PHMM, posterior horn of the medial meniscus; PM-Cap, posteromedial capsule.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 The complete repair picture of the posterior horn of medial meniscal peripheral capsular lesion from the camera in the posterolateral portal. (MFC, medial femoral condyle.) Arthroscopy Techniques 2016 5, e763-e767DOI: (10.1016/j.eats.2016.03.001) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions